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DR. JAEDEOK KIM LAC, PHD.
NPI 1144793134
Acupuncturist in Riverside, CA

Active since January 02, 2019
3858 CHICAGO AVE, RIVERSIDE, CA 92507(657) 252-1560(657) 234-4001 Get Directions Write a Review

NPPES record last updated: March 14, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 14, 2019, Mar 7, 2019, Jan 2, 2019 (3 updates tracked since 2019).

About Dr. Jaedeok Kim Lac, Phd. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAEDEOK KIM LAC, PHD. (NPI 1144793134) is an individual acupuncturist in Riverside, California, licensed in California (18321) and active in the NPI registry since January 2019. He maintains a secondary practice location in Tustin.

NPPES Registry Identity

NPI1144793134
Entity TypeIndividualMale
Primary Taxonomy171100000X
Provider Legal NameDR. JAEDEOK KIMCredential: LAC, PHD.
Location Address3858 CHICAGO AVERiverside, CA 92507-5354
Mailing Address1724 W Catalpa Ave Apt 305Anaheim, CA 92801-4054 · (657) 252-1560 · Fax (657) 234-4001
Phone(657) 252-1560
Fax(657) 234-4001
Sole ProprietorYes
Enumeration DateJanuary 2, 2019
Last NPPES UpdateMarch 14, 20193 updates tracked since enumeration
✔ NPI 1144793134 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAcupuncturistOther Service Providers
Taxonomy Code171100000X
License✔ Licensed in CA · 18321
Definition
An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.
3858 CHICAGO AVE, Riverside, CA 92507
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Secondary Practice Location 1

Location 114151 Newport Ave Ste 102Tustin, CA 92780-5174 · Phone (657) 252-1560 · Fax (714) 838-1114

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaedeok Kim's NPI number?

The NPI number for Jaedeok Kim is 1144793134. It was assigned to this individual provider in the NPPES registry on January 2, 2019.

Where is Jaedeok Kim located?

Jaedeok Kim practices at 3858 Chicago Ave, Riverside, CA 92507. The listed phone number is (657) 252-1560.

What is Jaedeok Kim's specialty?

The primary specialty registered for this NPI is Acupuncturist with taxonomy code 171100000X.

What insurance does Jaedeok Kim accept?

Health plans from Providence Health Plan list Jaedeok Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jaedeok Kim was last updated on March 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.